EP1195146B1 - Kit for the implantation of a dental implant - Google Patents

Kit for the implantation of a dental implant Download PDF

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Publication number
EP1195146B1
EP1195146B1 EP00203516A EP00203516A EP1195146B1 EP 1195146 B1 EP1195146 B1 EP 1195146B1 EP 00203516 A EP00203516 A EP 00203516A EP 00203516 A EP00203516 A EP 00203516A EP 1195146 B1 EP1195146 B1 EP 1195146B1
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EP
European Patent Office
Prior art keywords
implant
orifice
bone
fitting
root
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EP00203516A
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German (de)
French (fr)
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EP1195146A1 (en
Inventor
Jean-Paul Martin
Jean Heraud
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Individual
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Individual
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Priority to AT00203516T priority Critical patent/ATE291388T1/en
Priority to DE60018934T priority patent/DE60018934T2/en
Priority to EP00203516A priority patent/EP1195146B1/en
Priority to US09/972,768 priority patent/US6799970B2/en
Publication of EP1195146A1 publication Critical patent/EP1195146A1/en
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Publication of EP1195146B1 publication Critical patent/EP1195146B1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089Implanting tools or instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0018Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the shape
    • A61C8/0037Details of the shape
    • A61C8/0039Details of the shape in the form of hollow cylinder with an open bottom
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0089Implanting tools or instruments
    • A61C8/0092Implanting tools or instruments for sinus lifting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00Filling or capping teeth
    • A61C5/60Devices specially adapted for pressing or mixing capping or filling materials, e.g. amalgam presses
    • A61C5/62Applicators, e.g. syringes or guns
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003Not used, see subgroups
    • A61C8/0004Consolidating natural teeth
    • A61C8/0006Periodontal tissue or bone regeneration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/001Multiple implanting technique, i.e. multiple component implants introduced in the jaw from different directions

Definitions

  • the invention relates to dental implants.
  • a dental implant is the prosthetic equivalent of the root of a tooth. Without it appearing, the root of a tooth is endowed, under a very small volume, with astonishing properties. It must be able to withstand stresses of the order of ten to thirty kilograms per cm 2 , its material must be able to withstand the mechanical stresses engendered by chewing.
  • the root is actually used to transmit the efforts masticatory muscles to the dental crown via the bones maxillary.
  • the contact between the bone support and the root therefore has a decisive importance.
  • the problem is that bone is not a homogeneous structure: under its walls very strong cortices extends its medullary area, spongy in appearance, offering a mechanical base negligible for an implant.
  • a dental implant must therefore It is imperative to cross the medullary area to anchor firmly in the cortical walls.
  • Implants dental devices therefore require at least 8 to 15 mm of bone structure to be put in place. This implementation place is done by screwing, after drilling the maxillary bone lower or higher.
  • This classification is based on the height of the maxillary sinus floor in the implant technique bicortical; SD1 corresponds to a floor height greater than 10mm.
  • SD2 corresponds to a floor height between 8 and 10mm, SD3 between 5 and 8mm, SD4 between 0 and 5mm (which requires filling).
  • EP-A-0 412 845 discloses an implant provided with projections circular and with transverse perforation for conventional implantations, which can be considered the closer to the implant included in the present invention.
  • US-A-5,797,741 discloses a method of implantation by clavettage.
  • a sliding table drill guide is screwed on the implant.
  • the role of the alveolar bone is to support the teeth. When these disappear, the bone, which has lost its proper function, is reabsorbed. The bone can also be degraded (for other reasons (various conditions, tumors, etc.). For persons corresponding to higher stages of deterioration (SD 2, SD 3 and SD 4), the cortical parts of the bone support no longer have a sufficient thickness for the placement of an implant. In this case, a bone graft is performed in the maxillary sinus to increase the thickness of the bone support. Grafts of bone taken from the patient himself are used as grafts. After ossification (which itself takes, usually, of the order of 5 months), an implant can be placed according to the principles described above.
  • the object of the invention is to be able to treat SD2 or higher stages without treatment heavy. Another object of the invention is to be able to obtain immediate loading of the implanted tooth.
  • this at least one side port allow insertion by a needle hollow of a curable material in the internal cavity.
  • the internal cavity of the implant may also have an axial orifice to its distal end.
  • This at least one lateral orifice of the implant preferably has an oval section, the major axis of this oval section extending in a plane perpendicular to the axis of the root.
  • Figs. 1 to 3 show three possible variants of Implant 1 of the invention.
  • This implant has a conventional head 2, intended for support a dental prosthesis and a threaded root 4 in cylindrical substance.
  • a series of longitudinal grooves 6 formed on along the root allow the implant to tap the wall of the cell during its progression in the structure bone.
  • the root 4 is provided with a lateral orifice 8 of substantially oval shape which opens in a cavity 10 of the root 4, whose end is therefore hollow.
  • the lateral orifice 8 can lead to different places of root 4 (see Fig. 1 and 2).
  • the root 4 may be provided with an axial orifice 12 opening towards its point.
  • Fig. 4 shows the implant 1 after its introduction in a maxillary bone 14.
  • the root 4 passes through the cortical wall 16 hard of the bone and plunges into the medullary zone 18, spongy, of the bone, which contains the marrow.
  • the position of the lateral orifice 8 on the root 4 is such that this orifice 8 opens into this medullary area 18 of bone 14.
  • Fig. 5 shows a later phase of the implementation of place of the implant 1: a tracking device 20 indicating the angular position of the lateral orifice 8, (in the occurrence a calibrated tab), has been clipped onto the head 2 of the implant ,.
  • the needle 22 of a device injection 23 was introduced, perforating the bone of the jaw, to the mouth 8 of the cavity 10 of the root 4.
  • the presence of the locating tab 20 makes the score very sure.
  • we inject through the needle a hardening biocompatible product 24 (cement, polymerizing or precipitant) in the implant 1. This injection is continued until the hardening product 24, overflowing from cavity 10, fill the volume periprosthetic, and adjacent medullary alveoli.
  • the expansion of the product 24 can be promoted by removing gradually the needle while continuing the injection, as shown in FIG. 5.
  • the implant 1 After the complete setting of the hardening product 24, the implant 1 is firmly implanted in the maxillary bone 14 and can be loaded without delay.
  • Fig. 6 is a cross-sectional view of 1.
  • the needle 22 may be a classic straight needle.
  • a curved needle 25 or, better still, a shape memory needle with a curved tip after its introduction.
  • the interest of a curved needle 25 is to increase the injection volume of the curable fluid on both sides of implant 1, up to the contralateral edge of the cortical reach of the bone, then, by removal of the needle 22, 25 up to the ipsilateral edge at the point input of the needle 22, 25.
  • the hardening product 24 is progressively colonized by the body and replaced by a bone base solid.
  • the length of the implant is considerably reduced (3 to 8 millimeters, depending on the height available, versus 8 to 15 mm for a conventional implant), this which allows to implant teeth even in patients inoperable by conventional methods.
  • Figs. 8 and 9 show how it is possible to strengthen the jaw during the placement of an implant the invention.
  • a needle 26 is introduced under control imaging through the maxillary bone 14 until under the mucosa 28 of maxillary sinus 30 in order to take off this mucosa 28.
  • the detachment is performed by a spatula shape memory described with reference to FIGS. 10 and 11.
  • This needle 26 whose tip is diamond or other is hollow and contains a shape memory mandrel 32 which once out of the needle unfolds to form a spatula 26 for taking off the mucosa.
  • a cement 24 of the same composition as previously can be injected by the needle 26 into the formed pocket between the detached mucosa 28 and the maxillary bone 14, which allows to recover from the height and to screw an implant 1 larger size.
  • the mucosa 28 may be peeled off by injection of a liquid, a gas or by manual separation, or by direct injection of the polymerizer or rushing.

Abstract

The implant, measuring 3 - 7 mm long and designed to be anchored in a bone structure, has a head (2) to support a dental prosthesis, and a threaded cylindrical root member (4) with an inner cavity and at least one lateral hole connected with it and in contact with the medullary zone of the bone (18) once implanted. The lateral hole can be oval in shape and is large enough to receive an inserted hollow needle (22) for injecting a self-hardening material into the inner cavity. The position of the hole is indicated by a detachable tongue (20) on the head of the implant.

Description

L'invention concerne les implants dentaires.The invention relates to dental implants.

Un implant dentaire est l'équivalent prothétique de la racine d'une dent. Sans qu'il y paraisse, la racine d'une dent est dotée, sous un très faible volume, de propriétés étonnantes. Elle doit pouvoir subir des contraintes de l'ordre de dix à trente kg par cm2, son matériau doit être à même de résister aux contraintes mécaniques engendrées par la mastication.A dental implant is the prosthetic equivalent of the root of a tooth. Without it appearing, the root of a tooth is endowed, under a very small volume, with astonishing properties. It must be able to withstand stresses of the order of ten to thirty kilograms per cm 2 , its material must be able to withstand the mechanical stresses engendered by chewing.

La racine sert en fait à transmettre les efforts masticatoires des muscles à la couronne dentaire via les os maxillaires. Le contact entre l'assise osseuse et la racine a donc une importance déterminante. Le problème est qu'un os n'est pas une structure homogène : sous ses parois corticales très résistantes s'étend sa zone médullaire, d'aspect spongieux, qui offre une assise mécanique négligeable pour un implant. Un implant dentaire doit donc impérativement traverser la zone médullaire pour s'ancrer fermement dans les parois corticales. Les implants dentaires actuels nécessitent donc au moins 8 à 15 mm de structure osseuse pour être mis en place. Cette mise en place se fait par vissage, après forage de l'os maxillaire inférieur ou supérieur.The root is actually used to transmit the efforts masticatory muscles to the dental crown via the bones maxillary. The contact between the bone support and the root therefore has a decisive importance. The problem is that bone is not a homogeneous structure: under its walls very strong cortices extends its medullary area, spongy in appearance, offering a mechanical base negligible for an implant. A dental implant must therefore It is imperative to cross the medullary area to anchor firmly in the cortical walls. Implants dental devices therefore require at least 8 to 15 mm of bone structure to be put in place. This implementation place is done by screwing, after drilling the maxillary bone lower or higher.

Cette technique n'est cependant applicable que pour les patients présentant un support osseux suffisant, ce qui correspond à une classification SD 1 en implantologie.However, this technique is only applicable for patients with sufficient bone support, which corresponds to an SD 1 classification in implantology.

Cette classification est basée sur la hauteur du plancher du sinus maxillaire dans la technique d'implants bicorticaux; SD1 correspond à une hauteur de plancher supérieur à 10mm. This classification is based on the height of the maxillary sinus floor in the implant technique bicortical; SD1 corresponds to a floor height greater than 10mm.

Suivant la même classification, SD2 correspond à une hauteur de plancher comprise entre 8 et 10mm, SD3 entre 5 et 8mm, SD4 entre 0 et 5mm (ce qui requiert un comblement) .Following the same classification, SD2 corresponds to a floor height between 8 and 10mm, SD3 between 5 and 8mm, SD4 between 0 and 5mm (which requires filling).

En outre, après mise en place du support de l'implant, on attend généralement près de cinq mois avant de pouvoir mettre la couronne dentaire en charge.In addition, after placing the support of the implant, we usually wait almost five months before we can put the dental crown in charge.

On connaít par EP- 336 082 un pivot dentaire à pas de vis servant à fixer une couronne dans la racine d'une dent. Des orifices sont prévus dans le pivot pour injecter un ciment axialement. Une telle technique n'est toutefois pas transposable au maxillaire. It is known from EP-336 082 a dental pivot to not of screw used to fix a crown in the root of a tooth. Orifices are provided in the pivot to inject a cement axially. Such a technique is, however, not not transposable to the maxillary.

EP-A-0 412 845 décrit un implant muni de projections circulaires et muni d'une perforation transversale pour implantations classiques, qu'on peut considéré comme le plus proche de l'implant inclus dans la présente invention.EP-A-0 412 845 discloses an implant provided with projections circular and with transverse perforation for conventional implantations, which can be considered the closer to the implant included in the present invention.

US-A-5, 797, 741 décrit une méthode d'implantation par clavettage.US-A-5,797,741 discloses a method of implantation by clavettage.

Un guide de forage à table coulissante est fixé par vissage sur l'implant.A sliding table drill guide is screwed on the implant.

Après perforation latérale du maxillaire, une à deux clavettes introduites transversalement immobilisent l'implant. After lateral perforation of the maxilla, one to two transversely inserted keys immobilize the implant.

L'os alvéolaire a pour rôle le soutien des dents. Lorsque celles-ci disparaissent, l'os, qui a perdu sa fonction propre, se résorbe. L'os peut également se dégrader (pour d'autres raisons (affections diverses, tumeurs, etc.).
Pour les personnes correspondant à des stades de détérioration plus élevés (SD 2, SD 3 et SD 4) les parties corticales du support osseux ne présentent plus une épaisseur suffisante pour la mise en place d'un implant. Dans ce cas, on réalise une greffe osseuse dans le sinus maxillaire pour augmenter l'épaisseur du support osseux. On utilise comme greffons des esquilles d'os prélevées sur le patient lui-même. Après ossification (qui prend elle-même, généralement, de l'ordre de 5 mois), on peut placer un implant selon les principes décrits ci-dessus.
The role of the alveolar bone is to support the teeth. When these disappear, the bone, which has lost its proper function, is reabsorbed. The bone can also be degraded (for other reasons (various conditions, tumors, etc.).
For persons corresponding to higher stages of deterioration (SD 2, SD 3 and SD 4), the cortical parts of the bone support no longer have a sufficient thickness for the placement of an implant. In this case, a bone graft is performed in the maxillary sinus to increase the thickness of the bone support. Grafts of bone taken from the patient himself are used as grafts. After ossification (which itself takes, usually, of the order of 5 months), an implant can be placed according to the principles described above.

Le but de l'invention est de pouvoir traiter les stades SD2 ou supérieurs sans recourir à un traitement lourd. Un autre but de l'invention est de pouvoir obtenir une mise en charge immédiate de la dent implantée.The object of the invention is to be able to treat SD2 or higher stages without treatment heavy. Another object of the invention is to be able to obtain immediate loading of the implanted tooth.

L'objet de l'invention est un nécessaire adapté à la mise en place d'un implant dentaire qui comprend :

  • un implant tel que décrit ci-dessous,
  • un fluide biocompatible durcissable;
  • un dispositif de repérage de l'orifice latéral de l'implant comprenant une languette amovible solidarisable sur la tête de l'implant
  • un dispositif d'injection à aiguille creuse permettant, l'implant étant en place, d'injecter le fluide biocompatible durcissable, au-travers de l'os, dans la cavité interne de l'implant par l'orifice latéral.
L'implant dentaire à ancrer dans une structure osseuse comprend une tête destinée à supporter une prothèse dentaire et une racine filetée en substance cylindrique, dans lequel la racine filetée présente une cavité interne et au moins un orifice latéral reliant cette cavité interne et la face latérale externe de la racine, la position axiale de cet orifice étant telle que lorsque l'implant est en position, cet au moins un orifice débouche sur une zone médullaire de la structure osseuse.The object of the invention is a kit adapted to the placement of a dental implant which comprises:
  • an implant as described below,
  • a curable biocompatible fluid;
  • a device for locating the lateral orifice of the implant comprising a detachable detachable tab on the head of the implant
  • a hollow needle injection device allowing the implant in place to inject the curable biocompatible fluid through the bone into the internal cavity of the implant through the lateral port.
The dental implant to be anchored in a bone structure includes a head for supporting a dental prosthesis and a substantially cylindrical threaded root, wherein the threaded root has an internal cavity and at least one lateral port connecting the internal cavity and the lateral face. external of the root, the axial position of this orifice being such that when the implant is in position, this at least one orifice opens on a medullary area of the bone structure.

Les dimensions de cet au moins un orifice latéral permettent l'introduction par une aiguille creuse d'un matériau durcissable dans la cavité interne.The dimensions of this at least one side port allow insertion by a needle hollow of a curable material in the internal cavity.

La cavité interne de l'implant peut aussi présenter un orifice axial à son extrémité distale.The internal cavity of the implant may also have an axial orifice to its distal end.

Cet au moins un orifice latéral de l'implant présente de préférence une section ovale, le grand axe de cette section ovale s'étendant dans un plan perpendiculaire à l'axe de la racine.This at least one lateral orifice of the implant preferably has an oval section, the major axis of this oval section extending in a plane perpendicular to the axis of the root.

La longueur axiale de l'implant est, de préférence, comprise entre 3 et 8 mm.

  • le cas échéant, une spatule rétractable dans une aiguille creuse ; de préférence, l'aiguille creuse est en un métal à mémoire de forme, capable de passer d'une forme initiale droite à une forme courbée
The axial length of the implant is preferably between 3 and 8 mm.
  • if necessary, a retractable spatula in a hollow needle; preferably, the hollow needle is made of a shape memory metal, capable of passing from a straight initial shape to a curved shape

D'autres particularités et avantages de l'invention ressortiront de la description ci-après de modes de réalisation particuliers, référence étant faite aux dessins, dans lesquels :

  • Les Fig. 1 à 3 sont des vues en perspectives de l'implant de l'invention;
  • Les Fig. 4, 5 et 7 sont des vues schématiques en perspective d'un implant de l'invention en cours de pose;
  • La Fig. 6 est une vue en coupe suivant le plan VI-VI de l'implant de la Fig. 4.
  • Les Fig. 8 et 9 sont des vues schématiques en perspective, avec arrachement, de deux stades de renforcement de la parois maxillaire pour un implant de l'invention.
  • Les Fig. 10 et 11 sont des vues schématiques d'une tête de spatule à lame escamotable suivant l'invention;
  • Other features and advantages of the invention will emerge from the following description of particular embodiments, reference being made to the drawings, in which:
  • Figs. 1-3 are perspective views of the implant of the invention;
  • Figs. 4, 5 and 7 are schematic perspective views of an implant of the invention being applied;
  • Fig. 6 is a sectional view along the plane VI-VI of the implant of FIG. 4.
  • Figs. 8 and 9 are diagrammatic perspective views, with tearing, of two stages of reinforcement of the maxillary wall for an implant of the invention.
  • Figs. 10 and 11 are schematic views of a spatula head with a retractable blade according to the invention;
  • Les Fig. 1 a 3 montrent trois variantes possibles de 1' implant 1 de l'invention.Figs. 1 to 3 show three possible variants of Implant 1 of the invention.

    Cet implant présente une tête 2 classique, destinée à supporter une prothèse dentaire et une racine filetée 4 en substance cylindrique.This implant has a conventional head 2, intended for support a dental prosthesis and a threaded root 4 in cylindrical substance.

    Une série de rainures longitudinales 6 ménagées le long de la racine permettent à l'implant de tarauder la paroi de l'alvéole pendant sa progression dans la structure osseuse. A series of longitudinal grooves 6 formed on along the root allow the implant to tap the wall of the cell during its progression in the structure bone.

    Près de sa partie distale, la racine 4 est munie d'un orifice latéral 8 de forme sensiblement ovale qui débouche dans une cavité 10 de la racine 4, dont l'extrémité est donc creuse.Near its distal part, the root 4 is provided with a lateral orifice 8 of substantially oval shape which opens in a cavity 10 of the root 4, whose end is therefore hollow.

    L'orifice latéral 8 peut déboucher à différents endroits de la racine 4 (voir Fig. 1 et 2). La racine 4 peut être munie d'un orifice axial 12 débouchant vers sa pointe.The lateral orifice 8 can lead to different places of root 4 (see Fig. 1 and 2). The root 4 may be provided with an axial orifice 12 opening towards its point.

    La Fig. 4 montre l'implant 1 après son introduction dans un os maxillaire 14. Comme on peut le constater, la racine 4 traverse la paroi corticale 16 dure de l'os et plonge dans la zone médullaire 18, spongieuse, de l'os, qui contient la moelle. La position de l'orifice latéral 8 sur la racine 4 est telle que cet orifice 8 débouche dans cette zone médullaire 18 de l'os 14.Fig. 4 shows the implant 1 after its introduction in a maxillary bone 14. As can be seen, the root 4 passes through the cortical wall 16 hard of the bone and plunges into the medullary zone 18, spongy, of the bone, which contains the marrow. The position of the lateral orifice 8 on the root 4 is such that this orifice 8 opens into this medullary area 18 of bone 14.

    La Fig. 5 montre une phase ultérieure de la mise en place de l'implant 1 : un dispositif de repérage 20 indiquant la position angulaire de l'orifice latéral 8, (en l'occurrence une languette calibrée), a été clipsé sur la tête 2 de l'implant,. L'aiguille 22 d'un dispositif d'injection 23 a été introduite, en perforant l'os de la mâchoire, jusqu'à l'embouchure 8 de la cavité 10 de la racine 4. La présence de la languette de repérage 20 (en combinaison avec l'imagerie médicale) rend le pointage très sûr. A ce moment, on injecte au travers de l'aiguille un produit biocompatible durcissant 24 (ciment, polymérisant ou précipitant) dans l'implant 1. Cette injection est poursuivie jusqu'à ce que le produit durcissant 24, débordant de la cavité 10, remplisse le volume périprothétique, et les alvéoles médullaires adjacentes. L'expansion du produit 24 peut être favorisée en retirant progressivement l'aiguille tout en poursuivant l'injection, comme montré à la Fig. 5. Fig. 5 shows a later phase of the implementation of place of the implant 1: a tracking device 20 indicating the angular position of the lateral orifice 8, (in the occurrence a calibrated tab), has been clipped onto the head 2 of the implant ,. The needle 22 of a device injection 23 was introduced, perforating the bone of the jaw, to the mouth 8 of the cavity 10 of the root 4. The presence of the locating tab 20 (in combination with medical imaging) makes the score very sure. At this moment, we inject through the needle a hardening biocompatible product 24 (cement, polymerizing or precipitant) in the implant 1. This injection is continued until the hardening product 24, overflowing from cavity 10, fill the volume periprosthetic, and adjacent medullary alveoli. The expansion of the product 24 can be promoted by removing gradually the needle while continuing the injection, as shown in FIG. 5.

    Après la prise complète du produit durcissant 24, l'implant 1 est solidement implanté dans l'os maxillaire 14 et peut être mis en charge sans délai.After the complete setting of the hardening product 24, the implant 1 is firmly implanted in the maxillary bone 14 and can be loaded without delay.

    La Fig. 6 est une vue en coupe transversale de l'implant 1. Comme représenté, l'aiguille 22 peut être une aiguille droite classique. Cependant, on peut également utiliser une aiguille courbe 25, ou, mieux encore, une aiguille à mémoire de forme dont la pointe se recourbe après son introduction. L'intérêt d'une aiguille courbe 25 est d'augmenter le volume d'injection du fluide durcissable des deux côtés de l'implant 1, jusqu'au bord controlatéral de la portée corticale de l'os, puis, par retrait de l'aiguille 22, 25 jusqu'au bord ipsilatéral au point d'entrée de l'aiguille 22, 25.Fig. 6 is a cross-sectional view of 1. As shown, the needle 22 may be a classic straight needle. However, we can also use a curved needle 25, or, better still, a shape memory needle with a curved tip after its introduction. The interest of a curved needle 25 is to increase the injection volume of the curable fluid on both sides of implant 1, up to the contralateral edge of the cortical reach of the bone, then, by removal of the needle 22, 25 up to the ipsilateral edge at the point input of the needle 22, 25.

    On a la possibilité d'injecter le fluide biocompatible durcissable par la lumière du trou prothétique qui peut être en communication avec l'apex de l'implant (voir la Fig. 2), ceci peut être réalisé par la tête de l'implant, par un embout prothétique placé sur cette tête ou par une aiguille mise en place à travers l'implant. Cette technique est intéressante au niveau mandibulaire.It is possible to inject the biocompatible fluid curable by the lumen of the prosthetic hole that can be in communication with the apex of the implant (see Fig. 2), this can be achieved by the head of the implant, by a prosthetic tip placed on that head or by a needle set up through the implant. This technique is interesting at the mandibular level.

    Les avantages du présent implant sur les implants classiques sont multiples. En effet, il n'est plus nécessaire d'attendre plusieurs mois avant l'ossification complète de la zone périprothétique, ce qui abrège considérablement le calvaire des patients et supprime les interventions intermédiaires multiples avant la pose des couronnes sur l'implant.The benefits of this implant on implants classics are multiple. Indeed, it is no longer necessary to wait several months before ossification complete periprosthetic area, which shortens patients' suffering and eliminates the multiple intermediate interventions before the crowns on the implant.

    En outre, le produit durcissant 24 est progressivement colonisé par l'organisme et remplacé par une assise osseuse solide.In addition, the hardening product 24 is progressively colonized by the body and replaced by a bone base solid.

    Enfin, la longueur de l'implant est considérablement réduite (3 à 8 millimètres, en fonction de la hauteur disponible, contre 8 à 15 mm pour un implant classique), ce qui permet d'implanter des dents même chez des patients inopérables par les méthodes classiques.Finally, the length of the implant is considerably reduced (3 to 8 millimeters, depending on the height available, versus 8 to 15 mm for a conventional implant), this which allows to implant teeth even in patients inoperable by conventional methods.

    Par ailleurs, si le patient présente une épaisseur d'os maxillaire 14 vraiment trop réduite il reste néanmoins possible de poser un implant 1 suivant l'invention en empiétant sur le volume des sinus maxillaires.Moreover, if the patient has a thickness maxillary bone 14 really too small it nevertheless remains possible to place an implant 1 according to the invention in encroaching on the volume of the maxillary sinuses.

    Avec un implant classique, cette méthode ne serait applicable qu'en introduisant une opération préparatoire très longue : dont l'ossification des greffons au revers de l'os maxillaire prendra près de 5 mois, jusqu'à l'obtention d'une paroi corticale suffisamment dure et stable pour y visser un implant.With a conventional implant, this method would not applicable only by introducing a preparatory operation very long: including the ossification of grafts on the reverse of the maxillary bone will take almost 5 months, until obtaining a sufficiently hard cortical wall and stable to screw an implant.

    Les Fig. 8 et 9 montrent comment il est possible de renforcer la mâchoire au cours de la pose d'un implant de l'invention.Figs. 8 and 9 show how it is possible to strengthen the jaw during the placement of an implant the invention.

    Une aiguille 26 est introduite sous contrôle d'imagerie au travers de l'os maxillaire 14 jusque sous la muqueuse 28 du sinus maxillaire 30 afin de décoller cette muqueuse 28. Le décollement est réalisé par une spatule à mémoire de forme décrite en référence aux Fig. 10 et 11. Cette aiguille 26 dont la pointe est en diamant ou autre est creuse et contient un mandrin 32 à mémoire de forme qui une fois sorti de l'aiguille se déploie pour former une spatule 26 permettant de décoller la muqueuse. Après repli de la spatule 26 et retrait du mandrin 32 à mémoire de forme, un ciment 24 de même composition que précédemment peut être injecté par l'aiguille 26 dans la poche formée entre la muqueuse 28 décollée et l'os maxillaire 14, ce qui permet de récupérer de la hauteur et de visser un implant 1 de taille plus importante.A needle 26 is introduced under control imaging through the maxillary bone 14 until under the mucosa 28 of maxillary sinus 30 in order to take off this mucosa 28. The detachment is performed by a spatula shape memory described with reference to FIGS. 10 and 11. This needle 26 whose tip is diamond or other is hollow and contains a shape memory mandrel 32 which once out of the needle unfolds to form a spatula 26 for taking off the mucosa. After withdrawal of the spatula 26 and removal of the mandrel 32 with memory of form, a cement 24 of the same composition as previously can be injected by the needle 26 into the formed pocket between the detached mucosa 28 and the maxillary bone 14, which allows to recover from the height and to screw an implant 1 larger size.

    On notera que la muqueuse 28 peut être décollée par injection d'un liquide, d'un gaz ou par décollement manuel, ou encore par injection directe du polymérisant ou du précipitant.It will be noted that the mucosa 28 may be peeled off by injection of a liquid, a gas or by manual separation, or by direct injection of the polymerizer or rushing.

    Avec la technique d'implants immobilisés par scellement, on peut envisager de traiter SA2, SA3, SA4, mais aussi des cas mandibulaires où l'ostéoporose a fait disparaítre toute trace de trabéculation au niveau médulaire. Cette technique permettant l'immobilisation primaire (dès le premier temps chirurgical) de l'implant sans avoir un blocage bicortical; et donc une mise en charge immédiate de l'implant.With the technique of implants immobilized by sealing, it is possible to treat SA2, SA3, SA4, but also mandibular cases where osteoporosis has disappear any trace of trabeculation at the level medullary. This technique allows immobilization primary (from the first surgical time) of the implant without having a bicortical blockage; and therefore a setting immediate load of the implant.

    Claims (6)

    1. Kit designed for fitting a dental implant in place, comprising:
      an implant (1) for anchoring in a bone structure (14), comprising a head (2) intended to support a dental prosthesis and a threaded root (4) of cylindrical substance, wherein the threaded root (4) has an internal cavity (10) and at least one lateral orifice (8) through which this internal cavity (10) opens out on the external lateral face of the root (4), the axial position of this orifice (8) being such that when the implant (1) is in position, this at least one orifice (8) opens out on a medullary zone (18) of the bone structure (14) .
      a biocompatible hardenable fluid (24);
      a device (20) for indicating the position of the lateral orifice of the implant comprising a removable tongue (20) which can be attached to the head of the implant.
      a hollow needle injection device with which, when the implant (1) is in place, it is possible to inject the biocompatible hardenable fluid (24) through the bone and into the internal cavity (10) of the implant through the lateral orifice.
    2. Kit designed for fitting a dental implant in place according to Claim 1, characterized in that it additionally comprises:
      a spatula (32) which is retractable in a hollow needle (26).
    3. Kit designed for fitting a dental implant in place according to either of Claims 1 or 2, characterized in that the hollow needle is made of a shape-memory metal, capable of changing from an initial straight shape to a curved shape.
    4. Kit designed for fitting a dental implant in place according to either of Claims 1 to 3, characterized in that the internal cavity (10) of the implant has an axial orifice (12) at its distal end.
    5. Kit designed for fitting a dental implant in place according to any one of the preceding claims, characterized in that this at least one lateral orifice (8) of the implant has an oval cross section, the main axis of this cross section extending in a plane perpendicular to the axis of the root (4) .
    6. Kit designed for fitting a dental implant in place according to any one of the preceding claims, characterized in that the axial length of the implant is between 3 and 7 mm.
    EP00203516A 2000-10-09 2000-10-09 Kit for the implantation of a dental implant Expired - Lifetime EP1195146B1 (en)

    Priority Applications (4)

    Application Number Priority Date Filing Date Title
    AT00203516T ATE291388T1 (en) 2000-10-09 2000-10-09 SET FOR THE IMPLANTATION OF A DENTAL IMPLANT
    DE60018934T DE60018934T2 (en) 2000-10-09 2000-10-09 Set for the implantation of a dental implant
    EP00203516A EP1195146B1 (en) 2000-10-09 2000-10-09 Kit for the implantation of a dental implant
    US09/972,768 US6799970B2 (en) 2000-10-09 2001-10-05 Dental implant

    Applications Claiming Priority (1)

    Application Number Priority Date Filing Date Title
    EP00203516A EP1195146B1 (en) 2000-10-09 2000-10-09 Kit for the implantation of a dental implant

    Publications (2)

    Publication Number Publication Date
    EP1195146A1 EP1195146A1 (en) 2002-04-10
    EP1195146B1 true EP1195146B1 (en) 2005-03-23

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    Family Applications (1)

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    EP00203516A Expired - Lifetime EP1195146B1 (en) 2000-10-09 2000-10-09 Kit for the implantation of a dental implant

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    US (1) US6799970B2 (en)
    EP (1) EP1195146B1 (en)
    AT (1) ATE291388T1 (en)
    DE (1) DE60018934T2 (en)

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    Also Published As

    Publication number Publication date
    US6799970B2 (en) 2004-10-05
    DE60018934T2 (en) 2006-03-30
    US20020177102A1 (en) 2002-11-28
    DE60018934D1 (en) 2005-04-28
    ATE291388T1 (en) 2005-04-15
    EP1195146A1 (en) 2002-04-10

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